Esthetics Center for Dermatology PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

127728 Issued in NC

Legal business name

ESTHETICS CENTER FOR DERMATOLOGY PA

Practice address

353 Clement Ave
Charlotte, NC 28204-2431

Phone

(704) 370-2700

Fax

(704) 370-2702

NPI assigned

Oct 25, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Peggy A. Fuller, M.D.NPI 1598871345

Title

Owner

Phone

(704) 370-2700

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peggy A Fuller, MD

  • Specialist
  • Charlotte, NC
  • NPI 1598871345
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891879615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 CLEMENT AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042431",
            "telephone_number": "704-370-2700",
            "fax_number": "704-370-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 CLEMENT AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042431",
            "telephone_number": "704-370-2700",
            "fax_number": "704-370-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTHETICS CENTER FOR DERMATOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-370-2700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": "127728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stewart Esters
• Kevin Lowry Estes, DO
• Yana Patricia Estes, AUD
• Kari E Esteve, DPT
• Mary Susan Esther, M.D.
• Jennifer Estrada Arellano
• Christina Estrada, MA, LCMHCA, NCC
• Estramonte Chiropractic & Wellness Center
• Estramonte Chiropractic & Wellness Center East, P.a.
• Estramonte Chiropractic West PA

• Specialist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.